Possible concussion or beginning dementia? - AgingCare.com

Possible concussion or beginning dementia?

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Mom is 88 and had a fall two and a half years ago, during which she hit her forehead hard enough to cause two large hematomas on her forehead and fractured her neck, requiring surgery and a month and a half in the ICU, same amount of time in a "mini" hospital/rehab, then the same amount of time in an SNF/rehab. In the ICU, she had a code blue but heart never stopped. They had to do a tracheostomy and a stomach tube for feeding.


I live in California and she was in Ohio. I rushed there and spent the entire time with her in all the facilities. She had home health for about a month and did better with that than the rehab (comfort of home). In the beginning, much confusion and agitation (meds, I'm sure). After all tubes out and she could eat real food, she could not remember the recent past (like the accident, where she was living, things like 9/11, etc. Remembered all of her immediate family and close friends.


I brought her home to California with me. Got her hooked up with my doctor, who recommended other specialists (heart doctor, hearing, etc). All her results were excellent for her age. Forgot to mention she has severe osteoarthritis in both knees, elbows and a frozen shoulder. So she uses a walker and wheelchair when it's too far for her to walk.


A few weeks ago, she had blood when she had a bowel movement. Took her doctor who checked for hemorrhoids , and found none. Said take her to the ER. Seen by Gastroenterologist who wanted a Colonoscopy. Did this and he found Cancer. Surgery done about three weeks ago and that went very, very well. However, her Electrolytes took a nosedive and they had to pump her full of potassium, sodium and iron (she developed anemia). She was in and out of sleep every day and having "semi hallucinations". She had no pain from the surgery, so she wasn't taking pain meds after the first day.


After ten days brought her home. Befor this she was (with my help) washing herself, coloring in adult coloring books and able to go out an sit on the porch and enjoy fresh air, the birds and squirrels. We talked about her past which she remembers quite well. She still knows her family and friends, but she is still having some hallucinations - not realizing she's at home, or thinks there are or have been people here when that hasn't happened. Still very weak and not wanting to do the things she used to.


Sorry for writing a novel. I wasn't concerned before as except for the arthritis, she seemed to be getting better. I guess my question is, has anyone else experienced this or something similar and what have you done? Don't tell me she needs to be in some type of facility, as that is not something I am willing to do, unless she develops full blown Alzheimer's.


Thanks!

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Sandy, Please let us know how your mom is doing and what you find out. We care. ((((hugs)))))
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SandyB66 Jul 23, 2018
Thanks so much, BarbBrooklyn! I do so much appreciate everyone's concern! She is still having some "delusions", but her strength seems somewhat better. When she has her "moments", I sit with her and let her know that I love her very much and I will always take care of her. 😍
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How long was the surgery? You might want to get in touch with her doctor and ask how long you should give it until she returns to normal, but in my experience, surgeons aren't so good at figuring that out.

When my husband was 52, he had open heart surgery, which lasted from 7 AM until 1 PM. At his six week checkup, the surgeon said "you're fine! Take a vacation! Go to Florida!". As we left the office, my poor husband looked at me bedraggledly and said "do we HAVE to go to Florida?" I assured him that he could just go home and go to sleep. He told me the other day that it was 7 YEARS until he felt completely back to himself!
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SandyB66 Jul 20, 2018
Wow!! Okay, I will definitely talk to the doctor about that! Thanks again!
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Wow your poor Mom ( and you) have been through the wringer. One thing you may want to investigate with these ‘semi-hallucinations’ is your Moms actual vision. After we sorted out and corrected one by one Moms post hospital delirium, UTI caused delirium, Med interaction delirium, and morphine delirium, she occasionally still “saw” some things we couldn’t account for. An eye exam discover she had suffered an optic nerve stroke sometime recently and had lost much of her vision. I have no idea what she can still see, she sometimes sees her closet door and thinks a person is standing there, so probably just light and shadows. Compared to all her past real hallucinations, this doesn’t seem the same, and rather just really messed up vision. (She still tells me I’m pretty however! Ha) Anyway vision may be something for you to think about.
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SandyB66 Jul 20, 2018
Hi rocketjcat - thanks for that. She is due for an eye exam, I will have that done.
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Did she have general anesthesia for the surgery?

A hospital stay is always hard on an elderly person. But anesthesia can cause a lot of the symptoms you're describing. Some folks say that for every hour you're under, it takes a month to recover. Something to bear in mind if it's relevant.
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SandyB66 Jul 20, 2018
Thanks, BarbBrooklyn - I know part of her recovery is that it takes time for an elderly person. Yes she did have general anesthesia, but the surgery was a month ago -- can the effects of the anesthesia last that long? Thanks again!
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Hi Sandy

By coincidence my wife also fell a few years ago, hitting her head hard enough she had some bleeding on the brain. A year later she started showing definite signs of dementia. Whether these are connected or just a coincidence I don't really know.

You used the word "hallucinations". Just to clarify (as was done for me) A hallucination is if/when she thinks she see's someone right there in front of them at that moment. A "delusion" is a faulty memory wherein she remembers someone was "just here a few minutes ago" (but not in the present moment). My wife has delusions on a pretty consistent basis. She thinks our kids live with us, or her ex husband, or someone from my family has moved in with us (none of which is true)

My wife was always a very active person and very social. But since the dementia she has wanted to be with other people less and less. Sometimes I think it is because it is so exhausting for her to "get ready" to go somewhere. Other times I think she has grown to just like to stay home with me and the dog and watch this sweet funny show we found on tv (Thankfully it is 8 seasons, as we rewatch episodes pretty much every night) The main issue though is that she finds it difficult to "keep up with" conversations. She gets confused and that makes her uncomfortable and left out.

As for activities ... she physically has a harder and harder time. She was a huge gardener (flowers) but now can only do a little trimming once in a while for an hour or so. She gets tired very quickly. She also seems to have lost interest in trying to do things.

I too am trying to keep her at home as long as possible. But understand ... it will start taking a toll. My wife now needs lifting out of bed (and positioning into bed). Lifting from sitting. Help bathing, help using the bathroom, dressing, etc.

These are the things I try to do to help ....

1) IF she can do something ... let her. It is a matter of self worth.
2) Encourage her to go outside, even if it is just to sit and enjoy the fresh air.
3) Go along with her faulty memories ... when it is possible. (sometimes it is not as it will lead to more questions and faulty thoughts) Ex: She thinks someone is here that is not. I don't argue that they were here. I simply say they went home. If I agreed they were here she m right say "tell that person to come here I want to talk to them"
4) Be certain she is taking her medications
5) Talk too the doctor about new or unmentioned symptoms. They may be able to adjust or add a medication that will help
6) Make sure to help her with a bath on a regular basis (beyond daily washing) While it is more work, it has the affect of "refreshing" same as for all of us.
7) Stay calm and avoid arguing. Even if she becomes belligerent and unreasonable. This can be very difficult sometimes and holding it in can cause you problems with depression and so on. Watch yourself, take care of yourself. Talk to the doctor about how you are doing.
Visit here and just read to know you are not alone. You will find some peace and satisfaction in sharing.

David
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SandyB66 Jul 20, 2018
Hi David, thank you so much -- delusions is a much more appropriate word! Your suggestions are extremely helpful and I will implement them right away!
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It maybe that the anesthesia from the recent surgery and anesthesia (three weeks ago) along with the electrolytes imbalance has impacted your Mom negatively.  Elderly people often have problems with anesthesia and are confused and disoriented for a while after surgery.  Sometimes the confusion and disorientation disappear or decrease while others never are "themselves" after the surgery.  It could take a couple of months before you know what long range effects the surgery and anesthesia and the electrolyte imbalance have on your Mom.  GOOGLE search for  "anesthesia and the elderly" and "electrolyte imbalance and the elderly" and I think that you will find some helpful information.
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SandyB66 Jul 20, 2018
Thanks, DeeAnna -- I will GOOGLE that information.
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